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Mortality among sheet metal workers participating in a medical screening program
John Dement1, Laura Welch, Elizabeth Haile
1Division of Occupational & Environmental Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. john.dement@duke.edu
American Journal of Industrial Medicine
|June 30, 2009
Summary
Sheet metal workers face increased risks of asbestos-related diseases, including lung cancer and mesothelioma. Even low-level asbestos exposure, indicated by chest X-ray findings, elevates lung cancer risk in this occupational group.
Area of Science:
- Occupational Health
- Environmental Medicine
- Pulmonary Medicine
Background:
- The Sheet Metal Occupational Health Institute Trust (SMOHIT) initiated a study to investigate health hazards in the sheet metal industry.
- Focus on asbestos disease screening and mortality patterns among participants.
Purpose of the Study:
- To examine mortality patterns among sheet metal workers participating in an asbestos disease screening program.
- To assess lung cancer risk relative to chest X-ray findings and smoking history.
Main Methods:
- A cohort of 17,345 sheet metal workers with ≥20 years in the trade were followed from 1986-2004.
- Data included chest X-rays (International Labour Office criteria) and smoking history.
- Standardized mortality ratios (SMRs) and Cox proportional hazards models were used.
Main Results:
- Overall mortality was reduced (SMR=0.83), but excess mortality observed for pleural cancers, mesothelioma, and asbestosis.
- Lung cancer and COPD SMRs increased with International Labour Office (ILO) profusion scores.
- Cox models showed increased lung cancer risk with ILO scores of 0/1 (RR=1.17) and a trend with higher scores.
Conclusions:
- Sheet metal workers have elevated risks for asbestos-related diseases.
- The study supports increased lung cancer risk, even with indirect asbestos exposure and low ILO scores.
